Journal of Clinical Neurology最新文献

{"title":"Treatment Outcome After Switching From Galcanezumab to Fremanezumab in Patients With Migraine.","authors":"Michelle Sojung Youn, Namoh Kim, Mi Ji Lee, Manho Kim","doi":"10.3988/jcn.2023.0311","DOIUrl":"10.3988/jcn.2023.0311","url":null,"abstract":"<p><strong>Background and purpose: </strong>Monoclonal antibodies (mAbs) targeting calcitonin-gene-related peptide (CGRP) or its receptor (anti-CGRP-R) have been widely administered to patients with migraine who show inadequate responses to preventive medications. Among patients in whom a particular anti-CGRP-R mAb is ineffective, switching between different anti-CGRP-R mAbs can be the next option. Few studies have investigated treatment outcomes for antibody switching, especially between mAbs with the same target of the CGRP ligand. We aimed to determine the treatment outcome after switching between two anti-CGRP mAbs (galcanezumab to fremanezumab).</p><p><strong>Methods: </strong>We identified migraine patients in a prospective headache clinic registry who received galcanezumab for ≥3 months and were switched to fremanezumab for a further ≥3 months at a single university hospital. We defined a treatment response as a ≥50% reduction in the number of days with a moderate or severe headache at the third month of treatment relative to baseline. The treatment response after switching to fremanezumab was compared with the initial treatment response to galcanezumab.</p><p><strong>Results: </strong>Among 21 patients identified in the registry, 7 (33.3%) were initial responders to galcanezumab. After switching to fremanezumab, 7 (33.3%) showed a treatment response. The treatment response rate was 28.6% in the initial responders and 71.4% in the nonresponders to galcanezumab (<i>p</i>>0.999).</p><p><strong>Conclusions: </strong>Switching between anti-CGRP mAbs (galcanezumab to fremanezumab) yielded a treatment outcome comparable to that reported previously when switching from an anti-CGRP-R mAb (erenumab) to an anti-CGRP mAb (galcanezumab or fremanezumab). The treatment response to fremanezumab seems to be independent of the prior treatment response to galcanezumab. Our findings suggest that switching to another anti-CGRP mAb can be considered when a particular anti-CGRP mAb is ineffective or intolerable.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 3","pages":"300-305"},"PeriodicalIF":3.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Intraoperative Neurophysiological Monitoring With Human Reflexes.","authors":"Jongsuk Choi, Alba Díaz-Baamonde, María de Los Ángeles Sánchez Roldán, Ana Mirallave Pescador, Jun-Soon Kim, Maria J Téllez, Kyung Seok Park, Vedran Deletis","doi":"10.3988/jcn.2023.0416","DOIUrl":"10.3988/jcn.2023.0416","url":null,"abstract":"<p><p>Human reflexes are simple motor responses that are automatically elicited by various sensory inputs. These reflexes can provide valuable insights into the functioning of the nervous system, particularly the brainstem and spinal cord. Reflexes involving the brainstem, such as the blink reflex, laryngeal adductor reflex, trigeminal hypoglossal reflex, and masseter H reflex, offer immediate information about the cranial-nerve functionality and the overall state of the brainstem. Similarly, spinal reflexes such as the H reflex of the soleus muscle, posterior root muscle reflexes, and sacral reflexes provide crucial information about the functionality of the spinal cord and peripheral nerves. One of the critical benefits of reflex monitoring is that it can provide continuous feedback without disrupting the surgical process due to no movement being induced in the surgical field. These reflexes can be monitored in real time during surgical procedures to assess the integrity of the nervous system and detect potential neurological damage. It is particularly noteworthy that the reflexes provide motor and sensory information on the functional integrity of nerve fibers and nuclei. This article describes the current techniques used for monitoring various human reflexes and their clinical significance in surgery. We also address important methodological considerations and their impact on surgical safety and patient outcomes. Utilizing these methodologies has the potential to advance or even revolutionize the field of intraoperative continuous monitoring, ultimately leading to improved surgical outcomes and enhanced patient care.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 2","pages":"119-130"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancement of Surgical Precision and Safety by Human Reflex Monitoring: Remembering a Pioneer in Intraoperative Neurophysiology Whose Legacy Lives On.","authors":"Jongsuk Choi, Maria J Téllez, Kyung Seok Park","doi":"10.3988/jcn.2024.0021","DOIUrl":"10.3988/jcn.2024.0021","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 2","pages":"113-114"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Directions in Infection-Associated Ischemic Stroke.","authors":"Jin-Man Jung, András Gruber, Peter Heseltine, Kumar Rajamani, Sebastián F Ameriso, Mark J Fisher","doi":"10.3988/jcn.2023.0056","DOIUrl":"10.3988/jcn.2023.0056","url":null,"abstract":"<p><p>The relationship between infections and stroke has not been fully characterized, probably delaying the development of specific treatments. This narrative review addresses mechanisms of stroke linked to infections, including hypercoagulability, endothelial dysfunction, vasculitis, and impaired thrombolysis. SARS-CoV-2, the virus that causes COVID-19, may promote the development of stroke, which may represent its most severe neurological complication. The development of specific therapies for infection-associated stroke remains a profound challenge. Perhaps the most important remaining issue is the distinction between infections that trigger a stroke versus infections that are truly incidental. This distinction likely requires the establishment of appropriate biomarkers, candidates of which are elevated levels of fibrin D-dimer and anticardiolipin/antiphospholipid antibodies. These candidate biomarkers might have potential use in identifying pathogenic infections preceding stroke, which is a precursor to establishing specific therapies for this syndrome.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":" ","pages":"140-152"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Meningoencephalomyelitis Following Varicella Zoster Virus Infection.","authors":"Guorong Zhang, Chen Liu, Jin Song, Yuzhong Wang","doi":"10.3988/jcn.2023.0332","DOIUrl":"10.3988/jcn.2023.0332","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 2","pages":"223-225"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial-Membrane-Protein-Associated Neurodegeneration in Longitudinal Magnetic Resonance Imaging Over 11 Years of Follow-Up.","authors":"Jiyun Lee, Jin Ju Kim, Chul Hyoung Lyoo, Yun Joong Kim","doi":"10.3988/jcn.2023.0336","DOIUrl":"10.3988/jcn.2023.0336","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 2","pages":"220-222"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Familial Brain Calcification With <i>XPR1</i> Mutation Presenting With Cognitive Dysfunction.","authors":"Sojung Yoon, Seok Jong Chung, Yun Joong Kim","doi":"10.3988/jcn.2023.0284","DOIUrl":"10.3988/jcn.2023.0284","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"20 2","pages":"229-231"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothalamic-Pituitary-Adrenal Axis and Epilepsy.","authors":"Xueying Bian, Wenxian Yang, Jiannan Lin, Biao Jiang, Xiaoli Shao","doi":"10.3988/jcn.2023.0308","DOIUrl":"10.3988/jcn.2023.0308","url":null,"abstract":"<p><p>Epilepsy is a recurrent, transient seizure disorder of the nervous system that affects the intellectual development, life and work, and psychological health of patients. People with epilepsy worldwide experience great suffering. Stressful stimuli such as infection, mental stress, and sleep deprivation are important triggers of epilepsy, and chronic stressful stimuli can lead to frequent seizures and comorbidities. The hypothalamic-pituitary-adrenal (HPA) axis is the most important system involved in the body's stress response, and dysfunction thereof is thought to be associated with core epilepsy symptoms and related psychopathology. This article explores the intrinsic relationships of corticotropin-releasing hormone, adrenocorticotropic hormone, and glucocorticoids with epilepsy in order to reveal the role of the HPA axis in the pathogenesis of epilepsy. We hope that this information will yield future possible directions and ideas for fully understanding the pathogenesis of epilepsy and developing antiepileptic drugs.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":" ","pages":"131-139"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DPPX-Antibody-Associated Encephalitis Induced by Immune Checkpoint Inhibitor Treatment for Advanced Hepatocellular Carcinoma.","authors":"Yi Yang, Sisi Li, Dong Zhou, Jinmei Li","doi":"10.3988/jcn.2023.0381","DOIUrl":"10.3988/jcn.2023.0381","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":" ","pages":"214-216"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139424869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusion.","authors":"Je-Woo Park, Joon-Tae Kim, Ji Sung Lee, Beom Joon Kim, Joonsang Yoo, Jung Hoon Han, Bum Joon Kim, Chi Kyung Kim, Jae Guk Kim, Sung Hyun Baik, Jong-Moo Park, Kyusik Kang, Soo Joo Lee, Hyungjong Park, Jae-Kwan Cha, Tai Hwan Park, Kyungbok Lee, Jun Lee, Keun-Sik Hong, Byung-Chul Lee, Dong-Eog Kim, Jay Chol Choi, Jee-Hyun Kwon, Dong-Ick Shin, Sung Il Sohn, Sang-Hwa Lee, Wi-Sun Ryu, Juneyoung Lee, Hee-Joon Bae","doi":"10.3988/jcn.2023.0181","DOIUrl":"10.3988/jcn.2023.0181","url":null,"abstract":"<p><strong>Background and purpose: </strong>The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO).</p><p><strong>Methods: </strong>This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all-cause mortality within 1 year.</p><p><strong>Results: </strong>In total, 1,067 patients (age=67.2±13.1 years [mean±SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional-hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1-year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1-year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1-year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03-1.71) and stroke (aHR=1.32, 95% CI=1.00-1.75).</p><p><strong>Conclusions: </strong>The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":" ","pages":"175-185"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}